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Biomedical subjects

B Adamson

Publications and source records attributed to B Adamson.

16 recordsLinked to original sources
PubMed2003

A biopsychosocial model of pain and depression in rheumatoid arthritis: a 12-month longitudinal study.

OBJECTIVE: To cross-validate a biopsychosocial model using physical disability, helplessness and passive coping to predict depression and pain in rheumatoid arthritis (RA). METHODS: Clinical and psychological measures were collected from 157 RA patients at three time points over a period of 12 months. Path analysis was used for cross-sectional and longitudinal prediction of depression and pain. RESULTS: Helplessness and passive coping were found to be significant mediators of the relationship between the physical disability and future depression and pain. Cross-sectionally, the predictive model could account for 52-94% of the variance of pain and 37-71% of the variance of depression. Longitudinally, the predictive model could explain 29-43% of the variance of pain and 21-33% of the variance of depression. CONCLUSIONS: These results suggest that physical disability, helplessness and passive coping have a significant impact on the levels of pain and depression experienced by RA patients.

Adaptation, Psychological↗
PubMed2001

Coping with stress in the workplace: implications for new health professionals.

Because health care professionals must provide high-quality care while simultaneously adjusting to the new demands of a rapidly changing health care system, work stress and possibly even burnout are prevalent issues for both senior professionals and recent health science graduates upon entry into the workforce. This article examines the experience of stress and the importance of coping abilities, particularly focusing on students enrolled in health professional courses and those who have recently entered the workforce. It also presents research pertaining to whether newly graduated health professionals are coping effectively with the demands of work. Suggestions for improving stress-coping abilities are given.

Adaptation, Psychological↗
PubMed2000

Onycholysis as a complication of systemic chemotherapy: report of five cases associated with prolonged weekly paclitaxel therapy and review of the literature.

BACKGROUND: Onycholysis has been reported in association with the use of several noncytotoxic drugs and with chemotherapy in 135 patients. Onycholysis may be precipitated by exposure to ultraviolet radiation. METHODS: The authors studied 91 patients who received paclitaxel and 187 patients who received doxorubicin. RESULTS: Onycholysis occurred in 5 of 21 patients who received > 6 courses of weekly paclitaxel, developing in the summer months in all 5 patients. It did not occur in patients who received fewer weekly paclitaxel courses or those who were treated every 3 weeks. Onycholysis did not occur in 187 patients who received doxorubicin. Review of the literature revealed that onycholysis is nearly exclusively associated with anthracycline and taxane therapy. CONCLUSIONS: Prolonged weekly paclitaxel, other taxanes, and anthracyclines cause onycholysis in some patients, which may be precipitated by exposure to sunlight. Patients receiving these drugs should protect their nails from sunlight.

Adult↗
PubMed2000

The impact of passive coping on rheumatoid arthritis pain.

OBJECTIVE: To determine the ability of coping to predict pain. METHODS: Data on 111 rheumatoid arthritis (RA) patients (86 women and 25 men) were gathered from a mail survey. Statistical analyses were conducted on a range of clinical and psychological variables: physical disability, disease duration, pain, depression, helplessness, and passive and active coping. Pain was measured with both the pain subscale of the Arthritis Impact Measurement Scales and a visual analogue scale, and coping was measured with the Vanderbilt Pain Management Inventory. RESULTS: A series of multiple regression analyses revealed that the optimal predictors of pain in RA were physical disability and passive coping, which accounted for 40% of the variance associated with pain. Path analysis revealed that passive coping mediates between the physical disability and pain, and between physical disability and depression. CONCLUSION: The results of this study have implications for the overall management of RA. In addition to the medical treatment, the experience of pain and depression in RA should be addressed through an intervention programme designed to enhance coping strategies.

Adaptation, Psychological↗
PubMed1999

The creation of a profession leader role in an academic health sciences centre.

The introduction and administration of any new role in a dynamic changing environment requires strong leadership and specific, purposeful administrative strategies. This article describes the development of a professional leader role at one campus of a recently merged academic health sciences centre. Understanding the operational challenges may help other healthcare organizations that wish to introduce and refine professional leadership roles.

Academic Medical Centers↗
PubMed1997

The effect of microdebriders on tissue for histological diagnosis.

Microdebriders are an innovation in endonasal surgery which enable accurate and precise removal of tissue without damaging the surrounding mucosa. Concern has been expressed, however, that the instrument may render excised tissue unsuitable for histological diagnosis. This problem is further compounded by the fact that the Hummer (Stryker UK Ltd) microdebrider does not incorporate a mechanism for collecting specimens at the time of removal. Twenty-one patients with sinonasal polyposis underwent endoscopic sinus surgery using the microdebrider. Specimens were collected at the time of surgery via an in-line specimen trap. Simultaneous conventional biopsies of adjacent tissue were taken for comparison. The tissue was fixed in formalin then routinely processed to paraffin wax prior to staining with haematoxylin and eosin (H&E). A histological diagnosis was made in all 21 patients. A single unsuspected transitional cell papilloma was found. The remaining 20 specimens consisted of inflammatory nasal polypi. In two non-caseating granulomas were identified. Traumatic artefact was limited to the respiratory epithelium. The sub-epithelial tissue was unaffected and metaplastic epithelium appeared intact. The use of microdebriders does not preclude the submission of tissue for histological analysis. Tissue obtained has limited artefact and is suitable for pathological diagnosis.

Adult↗
PubMed1996

Delayed repair: the role of glutathione in a rat incisional wound model.

Glutathione is a low molecular weight tripeptide that is a major intracellular antioxidant, modulates DNA synthesis, and may regulate signal transduction mechanisms. Our previous studies in rats suggested that intracellular stores of glutathione were sensitive to skin ischemia and, therefore, may regulate the early temporal course of wound healing. A 4-cm incision was placed on a rat's back and in vivo wound strength was measured over time. Animals were depleted of glutathione using L-buthionine-(S,R)-sulfoximine (BSO), an inhibitor of the enzyme gamma-glutamylcysteine synthetase. Some animals were treated in combination with allopurinol/BSO or with allopurinol alone. The data demonstrated at 4 days that BSO treatment produced a fourfold reduction in glutathione (3.51 +/- 1.78) over baseline (16.15 +/- 2.18) levels and twofold reduction (5.0 +/- 1.1) over untreated sham controls (11.1 +/- 2.3) (P < 0.05). Allopurinol provided no protection to glutathione levels. BSO treatment alone reduced wound burst strength compared to the other groups (P < 0.05). Allopurinol treatment enhanced wound strength over sham controls and BSO groups at 9 days after wounding (P < 0.05). Hydroxyproline content in wounds accumulated faster by Day 4 in the BSO-treatment groups compared to sham controls (P < 0.05), whereas the BSO-treatment groups had lower hydroxyproline levels measured at Day 6 (P < 0.05). These data provide the first evidence that wound healing is related to the temporal course of glutathione metabolism. The effect may not be related to oxidant stress since allopurinol provided enhanced wound burst strength without protecting wound glutathione levels.

Allopurinol↗
PubMed1995

Oxidant stress: the role of the glutathione redox cycle in skin preconditioning.

The role of the glutathione redox cycle in cellular protection form skin necrosis during the ischemic stress response (preconditioning) is unknown. In this series of experiments, we tested the hypothesis that oxidant stress reduces available total glutathione during injury and contributes to skin necrosis in flaps. Dorsal skin flaps (10 x 4 cm) were raised as acute flaps and skin grafts were obtained from the flaps at 0, 1, 4, 6, 12, or 24 hr. Some flaps were preconditioned as bipedicle flaps for 24, 48, 72, or 96 hr and the distal attachment divided before skin grafts were obtained 24 hr later. Flap survival was measured at 7 days. Total glutathione (GSH) and oxidized GSH (GSSG) were extracted and their levels determined enzymatically. Tissue GSH reductase (GR) activity was assayed with a spectrofluorometer and expressed as mumoles of NADPH oxidized/hr/g. Biochemical data were compared between the proximal and distal ends of the flaps using a two-tailed Student t test while differences between groups were compared using ANOVA. Skin necrosis was 5.4 +/- 0.12 cm in the distal ends at 7 days in acute flaps, while there was no skin necrosis in flaps preconditioned for 7 days. In acute flaps, total GSH levels fell precipitously in the distal end at 24 hr (P < 0.05). However, after 72 hr of preconditioning, the GSH levels in the distal end of the flap remained elevated while GSSG levels were undetectable. At 24 hr of ischemia, GR activity was 79 +/- 4 in the distal ends of acute flaps, while after preconditioning and 24 hr of ischemia, the GR activity increased to 172 +/- 13 in the distal ends (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Medicine and the health professions: issues of dominance, autonomy and authority.

Medical dominance of health care has traditionally been the organising principle in health care delivery. Medical power is manifested through the professional autonomy of doctors, through their pivotal role in the economics of health services, through dominance over allied health occupational groups, through administrative influence, and through the collective influence of medical associations. Using Friedson's four factor definition of medical dominance, a structured interview schedule was developed to examine one aspect of medical dominance, that is, doctors' control over the allied health professions. Ninety interviews were carried out with a sample of nurses, physiotherapists, occupational therapists, speech pathologists and psychologists working in various health care settings in metropolitan Sydney, seeking their perceptions on the way in which the medical profession interacts with their occupational group. The findings indicate that a significant proportion (73%) of health professionals did not feel regarded as professional equals by doctors. Nor did they feel that doctors had an adequate knowledge and understanding of their professions (73%). However, the majority (74%) felt that they had sufficient autonomy and were able to discuss doctors' instructions and offer advice or suggestions to doctors. Length of service significantly contributed to perceptions of professional autonomy amongst allied health professionals. These results support the view that the increased autonomy of the allied health professions has not impinged on medical dominance in the health care delivery system. Recommendations for further research and the training of medical and allied health professionals are made.

Allied Health Personnel↗
PubMedDate not supplied

Job sharing of a director of nursing position: an evaluation report.

The authors report on a job-share experience of Director of Nursing position at a large teaching hospital. A number of methods are used to evaluate this interim four month experience. Using aspects of administrative theory and the results of this evaluation, a conceptual framework is provided and suggestions are made that they may assist nurse and non-nurse administrators when considering future middle management job sharing arrangements in their organizations.

Job Description↗
PubMedDate not supplied

Structural and perceived medical dominance: a study of barriers to nurses' workplace satisfaction.

Current literature on the sociology of healthy views medical dominance as a structural feature of the health division of labour and a body of literature has developed exploring the structural components that contribute to the subordination of the allied health professions. In this paper, Friedson's four factor definition of medical dominance was employed to provide a framework for assessing the degree to which structural medical dominance of the nursing profession impinges on nurses' perceptions of dominance and how structural and perceived medical dominance affects nurses' workplace satisfaction. A 69 item questionnaire covering aspects of doctor/nurse, doctor/patient, nurse/patient and nurse/hospital administration relationships was developed. One hundred and thirty nurses completed the questionnaire in which they ranked their own level of professional satisfaction and their perceptions of level of doctors' professional satisfaction. Results indicated that nurses were dissatisfied with many aspects of their work environment, i.e. pay and working conditions and experienced very high levels of dissatisfaction with their professional status. Nurses perceived doctors as being highly satisfied and as having more control over a range of procedures intrinsic to the delivery of health care, and the medical profession to be a more powerful and higher status profession that was held in greater regard by the public and other allied health professionals than nursing. The implications of the perceived discrepancy in nurses' and doctors, workplace satisfaction are discussed in terms of the structural barriers created by medical dominance. Implications of the findings for nurse education and nurse practitioners are also discussed, together with suggestions for further research.

Adult↗